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European Journal of Echocardiography Advance Access published online on July 7, 2008
European Journal of Echocardiography, doi:10.1093/ejechocard/jen186
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Spontaneous left atrial thrombus during patent foramen ovale closure

Lucy Hudsmith*, Sara Thorne and Paul Clift

The Queen Elizabeth Hospital, Birmingham, UK

Received 16 March 2008; accepted after revision 25 May 2008.

* Corresponding author: Tel: +44 121 627 2959. E-mail address: lucyhudsmith{at}hotmail.com


  Abstract

A 52-year-old male smoker suffered a left-sided stroke. Bubble contrast echocardiography demonstrated an aneurysmal atrial septum and patent foramen ovale (PFO). The patient was referred for percutaneous closure of his PFO to reduce his risk of further stroke. Despite dual antiplatelet therapy and pre-procedural heparin, he developed a spontaneous thrombus during balloon sizing of the defect identified by transoesophageal echocardiography. The balloon was immediately withdrawn to the right side and removed. Periprocedural echocardiography using either transoesophageal or intracardiac echo is essential to monitor for this potential procedural complication of percutaneous PFO closure.

Keywords: Patent foramen ovale; Transoesphageal echocardiography; Stroke; Atrial septal aneurysm; Thrombus


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